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Tribune. On October 6, the World Health Organization (WHO) recommended the RTS vaccine, S / AS01, developed by the British pharmaceutical group GSK, for the fight against malaria. In the media, articles dealing with this news have praised the scientific advance represented by the development of an antimalarial vaccine. However, with an estimated efficiency of 30%, what could be the consequences of its deployment in the field? To our knowledge, no article has examined this question.
In the early 2000s, malaria – a disease caused by a single-celled parasite transmitted by the bite of certain mosquitoes – killed 800,000 people a year, mostly young children in sub-Saharan African countries. The progress made over the past two decades has resulted in real improvement. But 400,000 people still die from it each year and the road to be covered to free oneself from this burden for good still seems long.
Currently, the fight against malaria is based on the prevention of the infectious bite of vector mosquitoes (in particular through mosquito nets), the rapid diagnosis of the infection and treatment with antiparasitic molecules (antimalarials). These drugs treat all cases of simple malaria with an effectiveness close to 100%. It is the combined use of these different tools that has reduced the number of victims to the current level.
Malaria is therefore a disease that can be prevented and cured, provided that the diagnosis is made and treatment administered as soon as possible after the onset of the first symptoms. The major challenge in further reducing the number of deaths is to increase access to this arsenal, which remains limited for the poorest populations and in the most remote areas.
Four injections in one year
Regarding the RTS vaccine, S / AS01, WHO recommends the administration of four doses to children from the age of 5 months. These four injections repeated in the space of one year provide an effectiveness of 30%, limited in time (from twelve to eighteen months).
Thus, among children infected with the parasite, only three in ten vaccinated would be protected from severe malaria attacks, while the other seven are still likely to develop the disease and die from it. While the scientific advance represented by this vaccine is undeniable, the announced medical significance can only be assessed with regard to the health and socio-economic context of each country concerned and the prophylactic and therapeutic regimens already implemented there.
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Malaria: “Why does the WHO recommend a vaccine that is only 30% effective?” ”